OBJECTIVE:To evaluate clinical efficacy and safety of mouse nerve growth factor combined with ganglioside in the treatment of hypoxic-ischemic encephalopathy (HIE). METHODS:A total of 150 HIE children in pediatric department of our hospital during Jan. 2013-Jan. 2015 were divided into control group and observation group according to random number table,with 75 cases in each group. Both groups received routine treatment as correcting hypotension,reducing intracranial pressure,etc. Con-trol group was additionally given Monosialotetrahexosylganglioside sodium injection 20 mg added into 10% Glucose injection 30-50 mL,ivgtt,qd. Observation group was additionally given Mouse nerve growth factor for injection 30 μg added into Water for injection 2 mL,im,qd,on the basis of control group. A treatment course lasted for 10 days,and both groups received 2 courses of treatment. Clinical efficacies of 2 groups were compared as well as NBNA score,the levels of related lab test indexes (IL-10, TNF-α,SOD,NSE,VEGF) before and after treatment,the occurrence of ADR and sequela (following up to 1 year old). RE-SULTS:The response rate of observation group was 86.7%,which was significantly higher than 72.0% of control group,with sta-tistical significance(P<0.05). Before treatment,there was no statistical significance in NBNA scores or related lab test index lev-els between 2 groups (P>0.05). On 4th,7th,10th day after treatment,NBNA scores of 2 groups were increased significantly, compared to before treatment;the observation group was significantly higher than the control group,with statistical significance (P<0.05). After treatment,serum levels of IL-10,TNF-α,NSE and VEGF in 2 groups were decreased significantly,compared to before treatment,SOD levels were increased significantly,and the observation group was significantly better than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. Totally 64 children in ob-servation group and 60 in control group completed follow-up. The total incidence of sequela in observation group was 10.9%, which was significantly lower than 25.0% of control group,with statistical significance(P<0.05). CONCLUSIONS:For neonatal HIE,mouse nerve growth factor combined with ganglioside can effectively relieve brain tissue inflammatory reaction and oxidative stress injury,accelerate the recovery of cerebral tissue and reduce the occurrence of sequela with good safety.

Objective To investigate the clinical manifestations and pathogen distribution of the neonatal sepsis, and to analyze the antibiotic resistance of the pathogens. Methods Review the Medical records of 38 sepsis cases of full-term and premature neonates in our hospital from October 2011 to February 2014 were col-lected and analyzed. Results Ten cases were caused by Gram-positive bacteria among the 18 full-term neonates with sepsis. Eight of ten of the isolates were resistant to oxcillin. Nine of ten of the cases were belonged to late onset infection, and the cases with no nosocomial infection were found. In the other eight full-term neonatal cases caused by Gram-negative bacteria , six cases were nosocomial infection. Among the 20 premature neonates with sepsis , 17 cases were infected Gram-negative bacteria , in which Escherichia coli , Klebsiella pneumonia and En-terobacter cloacae were the most common agents (16/17). Early onset type and nosocomial infection were identi-fied for 11 (11/20) and 9 (9/20) cases in the premature neonates, respectively. The penicillin G, methicillin resistant rates of the Gram-positive bacteria were close to or over 70%. All the Gram-positive bacteria were sensi-tive to vancomycin. All the Gram-negative bacteria were resistant to amoxicillin , but over 60% of them were sen-sitive to piperacillin-tazobactam and other compounds containing enzyme inhibitor , and 100% of them were sensi-tive to carbapenems and aminoglycoside. Conclusion The full-term neonatal sepsis admitted into our hospital were mainly caused by Gram-positive bacteria , which were usually resistant to oxcillin. The premature sepsis were mainly caused by Gram-negative bacteria , which were always sensitive to carbapenems and aminoglycoside.

0.05).Conclusion The curative effect of moxibustion and Shenlingbaizhu pills are definite to AIDS associated diarrhea.The treatment can improve the quality of life of AIDS patients with good safety.

In order to observe the therapeutic effect of azithromycin combined with IFN-γ on mouse toxoplasmosis and its impact on the cellular immune function of mouse, a total of 100 BALB/c mice were selected and divided into 5 groups, namely an infection control group (Group A) , azithromycin treatment group (Group B) , azithromycin combined with IFN-γ treatment group (Group C) , IFN-γ treatment group (Group D) and blank control group (Group E). The mice in Group A, B, C, D were infected by Toxoplasma tachyzoites through intraperitoneal injection and those in Group B, C, D were treated with relative drugs 24 h later for S days. The survival time of mice in each group and the levels of CD4 ~+ and CD8~+ T cells in blood were observed. The results showed that azithromycin combined with IFN-γ could improve the therapeutic effect of mouse toxoplasmosis and the cellular immune function of mice.

Objective To investigate the clinical features and bronchoalveolar lavage (BAL)therapy of postinfectious bronchiolitis obliterans (BO) in children. Method Ten children, who had post-infectious BO from February 2009 to February 2010, received BAL therapy, and were retrospectively analyzed. The data included pathology,chnical feature,chest HRCT scan, BALF cellular, levels of blood T cell subtypes and outcome of BAL therapy. Results Adenoviruses or mycoplasma pneumoniae were the most common etiologic agents (4/10, respectively). All patients presented persistent or recurrent dyspneic respirations and wheezing since the initial lung infection. The findings of HRCT included mosaic pattern of perfusion (6/10), accompanied by gas retention,bronchiectasis, atelectasis and bronchial wall thickening. The percentage of neutrophils in BALF was significantly increased in all cases (10/10). There were predominance of CD8+ T cell subtype (9/10) and lower ratio of CD4 +/CD8+ ( 10/10)in blood. Reduced symptoms and shortened hospital stay of BO in 9 of all 10 cases were observed after BAL therapy. Conclusions Severe adenovirus or mycoplasma pneunoniae bronchiolitis and/or pneumonia has higher risk for developing BO in children. Increased percentage of neutrophils in BALF and predominance of CD8 +T cell subtype may play an important role in the mechanism of BO. BAL therepy can reduce the respiratory symptoms of BO in children.

Objective To investigate the infection rate of Legionella pneumophila(LP)in children younger than 5 years with lower respiratory infections by ELISA and PCR.Method Serum LP-IgM and IgG were measured by ELISA,and LP DNA in sputum or throat swab were detected by PCR in 300 children less than 5 years with lower respiratory infections.The data were analyzed by chi-square test and the consistency of the two methods was analyzea by NcNemar test.Results Serum antibody detected by ELISA was positive in 17 cases(5.67%),including 10 positive of IgM and 7 positiile of lgG.In these 17 eases,11 were males and 6 were females with similar positive rates(5.76%vs 5.5%).Four cases(2.53%)were positive in children aged from 27 days to 1 year,while 7(7.37%)and 6 cases(12.77%)were positive in children aged 1-3 years and 3-5 years,respectively.Seven cases(5.19%)found in the winter and spring seasons and 10 cases(6.06%)in summer and autumn seasons.Eleven children(11.83%)were from urban area and only 6(2.9%)from countryside.DNA in sputum or throat swab detected by PCR was positive in 16 cases(5.33%),included 10 males and 6 females with similar positive rates(5.24%vs 5.5%).Five cases(3.16%)were positive in children aged from 27 days to 1 year,while 6(6.32%)and 5 cases(10.64%)were positive in children aged 1-3 years and 3-5 years,respectively.Three cases(2.22%)found in the winter and spring seasons and 13 cases(7.88%)in sunmmr and alltumll seasons.Nine children(9.68%)were from urban area and only 7(3.38%)from countryside.McNemar test was used to compare the data of ELISA and PCR results with a Qm of 0.037 and a Pr of 0.8474.Conclusions LP might contribute partly to the lower respiratory infections in children less than 5 years.The infection rate of LP increases with age increasing.Urban children have a higher infection rate than those living in countryside.Both methods have a good consistency.

Objective To research the effects of establishing core system key risk index in reducing adverse events. Methods Analyzed the causes of the 147 adverse events in 2014. Including the core system implementation of the reasons for the end of the adverse events caused, the data of fundamental reasons in adverse events and the high risk link that because nurses don′t practice the core system. In 2015, randomly checked the 29 nursing units, including 27 wards and emergency outpatient transfusion room, ICU. Contains the implement rates of the core system in transfusion treatment, day and night shifts, doctors′ advice and patients′ identification. In order to quarterly analysis the index and pertinently improve the results, assessors of quality administration council, head nurse in endemic area and attendant watch keeper are chosen to gather index data. Results After one year of management, the key aspects of the core system execution qualified rate has reached 95%, the check of the implementation of the system, the total pass rate compared with before had increased 6.94%, orders execution system implementation of a qualified rate had increased 9.33%, patient identification system implementation of qualified rate had increased 4.29%, the qualified rate of change of comparison the differences were statistically significant (P<0.05). After the establishment of the core system key risk index management, the adverse events had decreased 11.06%(P < 0.05). Conclusion The establishment of the core system key risk index management can effectively improve the implement rates and reduce the nurse adverse events.

Neurally adjusted ventilatory assist(NAVA)is a mode of ventilation in which both the timing and degree of ventilatory assist are controlled by the patient.Since NAVA uses the diaphram electrical activity (Edi)as the controller signal,it is possible to deliver synchronized non-invasive NAVA(NIV-NAVA)regardless of leaks and to monitor continuously patient respiratory pattern.Advantages of NIV-NAVA over conventional modes include improved patient-ventilator interaction,reliable respiratory monitoring and self-regulation of re-spiratory support.In theory,these characteristics make NIV-NAVA an ideal mode to provide effective,appropri-ate non-invasive support to newborns with respiratory insufficiency.NIV-NAVA has been successfully used clini-cally in neonates as a mode of ventilation to prevent intubation,to allow early extubation,and as a novel way to deliver nasal continuous positive airway pressure.

Objective To investigate the effects of liver X receptor (LXR) agonist on the proliferation of mouse pancreatic β cell line MIN6 cells.Methods The viability,changes of cell cycle,mRNA levels of S phase kinase associated protein 2 (Skp2) and p27,and protein levels of Skp2 and p27 in MIN6 cells treated with LXR agonist T0901317 were determined by the CCK-8 method,flow cytometry,real-time RT-PCR and western blot,respectively.Results The viability of MIN6 cells treated with 1 μmol/L,5 μmol/L and 10 μnol/L of T0901317 were (98.54 ±0.94)％,(87.03 ±0.93)％ and (75.57 ± 1.85)％ of the controls,respectively,and there was significant difference among them (F =301.90,P ＜ 0.01).The percentages of G1 phase cells in the MIN6 cells treated with 0 μmol/L,1 μmol/L,5 μmol/L and 10 μmol/L of T0901317 were (35.93 ±2.25)％,(38.45 ±0.91)％,(45.46±1.34)％ and (53.28 ± 1.14) ％,respectively,and there was significant difference among them (F =80.83,P ＜ 0.01).Similarly,the percentages of S phase cells in the MIN6 cells treated with 0 μmol/L,1 μmol/L,5 μmol/L and 10 μmoi/L of T0901317 were (52.87 ± 1.19) ％,(48.65 ± 0.85) ％,(36.31 ± 1.37) ％ and (31.45 ± 1.22) ％,respectively,and there was also significant difference among them (F =221.30,P ＜ 0.01).The protein levels of p27 in the MIN6 cells treated with 10 μmol/L of T0901317 (2.84 ± 0.14) were significantly higher than that in the controls (2.28 ± 0.10) (t =4.54,P ＜ 0.05),while there was no significant difference in the mRNA levels of p27 between them (t =0.28,P ＞ 0.05).However,10 μmol/L of T0901317 significantly decreased mRNA (0.52 ± 0.02,t =29.22,P ＜ 0.01) and protein levels (0.98 ± 0.12 vs 1.89 ± 0.01,t =10.98,P ＜ 0.01) of Skp2 in MIN6 cells.Based on the control siRNA transfection group as a reference (100％),the cell survival rates of the p27 siRNA transfection group,10 μmol/L of T0901317 treatment group and the intervention group (p27 siRNA transfection + T0901317 treatment) were (100.97 ± 1.08) ％,(75.03 ± 1.83) ％ and (86.67 ± 2.45) ％,respectively.There was no significant difference between the control siRNA and p27 siR-NA transfection groups (t =1.542,P ＞ 0.05).Compared with the control siRNA transfection group,the cell survival rates of the T0901317 treatment group decreased (t =23.58,P ＜ 0.01).There was also significant difference in the cell survival rates between the T0901317 treatment group and the intervention group (t =7.77,P ＜ 0.01).Conclusion The activation of LXR may induce pancreatic β cell cycle arrest by up-regulating the expression of p27 and down-regulating the expression of Skp2.

Objective:To report a rare case of early onset epileptic encephalopathy caused by YWHAG gene mutation, and discuss the clinical and genetic characteristics as well as the diagnosis, treatment and prognosis of the disease.Methods:Clinical data of the patient with YWHAG gene deficiency from Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University were collected in January 2018. The whole exome sequencing was performed on the core members of the family, and the characteristics of gene mutations were analyzed.Results:The proband is a girl, three years and 10 months old, presented to the outpatient department of neurology with a history of six-month intermittent convulsions, manifested as epilepsy seizures, mental retardation, motor delay and gait instability, ataxia. The brain magnetic resonance imaging showed myelinated dysplasia, and long-term video electroencephalogram (EEG) showed extensive 1.5-3.0 Hz slow spikes, and multiple spikes during sleep. During the monitoring, the children had clinical seizures and abnormal EEG discharges, indicating that myoclonus was accompanied by atypical absence of consciousness. Whole exome sequencing on the proband detected a de novo mutation c.169C>T (p.Arg57Cys) in YWHAG gene. According to American College of Medical Genetics guidelines (2015), the mutation was considered potentially pathogenic.Conclusion:Early epileptic encephalopathy caused by YWHAG gene mutation is very rare, and the variation of YWHAG gene c.169C>T is the possible pathogenic variation of the genetic cause of early onset epileptic encephalopathy in the proband.